The Health Care Bill’s Insults to Women

When Representative John Shimkus questioned, during a debate in March, why men have to pay for prenatal care, it was a sign of things to come. Soon Sean Spicer, the White House press secretary, was joking that older men didn’t need maternity care. When asked about repealing a requirement of the Affordable Care Act, Senator Pat Roberts replied, “I wouldn’t want to lose my mammograms.”

These sophomoric jokes and flippant disregard for women’s health by Republicans would have been bad enough had they not been followed by the passage in the House of the American Health Care Act.

If it becomes law, it will harm millions of Americans, including the poor, sick and elderly. But it will be especially disastrous for women. Among other damaging provisions, it:

STRIPS FUNDING FROM PLANNED PARENTHOOD About half of the 2.5 million patients who visit Planned Parenthood centers every year, and about 20 percent of women of reproductive age nationwide, rely on Medicaid for their health coverage. Under the House bill, they would no longer be able to use Medicaid for care at Planned Parenthood centers, more than half of which are in rural or underserved areas. In 105 counties, Planned Parenthood operates the only clinic offering a full range of reproductive health services.

PUTS ESSENTIAL SERVICES AT RISK The House bill eliminates the Affordable Care Act requirement that insurers cover certain essential services. Many of these services, like mammograms, birth control, and prenatal and maternity care, are used primarily by women. Women are more likely than men to use mental health care and prescription drugs, both of which are considered essential under the Affordable Care Act. If the requirement is scrapped, plans could choose not to offer such services. Plans that offer maternity care could become prohibitively expensive.

SLASHES MEDICAID By cutting $880 billion from Medicaid over 10 years, the House bill removes a crucial source of coverage for many women’s health services. Almost half of all births in the country, and 75 percent of publicly funded family planning services, are covered by Medicaid. Slashing Medicaid funds would be especially harmful to black and Latina women, who are more likely than white women to be insured through Medicaid.

ELIMINATES PRE-EXISTING CONDITION PROTECTIONS The bill allows states to waive the requirement that insurers cover people with pre-existing conditions without charging higher premiums. While it’s not yet clear how insurers would respond, many of the conditions that prompted insurers to deny coverage or raise premiums before the requirement was in place, including depression, lupus and multiple sclerosis, are more common in women. Some insurers also denied coverage or charged higher premiums to women who had given birth by C-section.

ENDANGERS ABORTION COVERAGE The bill bars anyone from using federal subsidies to buy insurance that covers abortion. It also bars small employers from using tax credits to pay for plans that cover abortion for their employees. The likely result: Most insurers would drop abortion coverage, and the few plans that did cover abortion would become prohibitively expensive.

The bill now goes to the Senate, where the majority leader, Mitch McConnell, initially convened a health care working group composed of 13 men and no women. Following widespread criticism, the group invited Senator Shelley Moore Capito, Republican of West Virginia, to a meeting, but it is unclear whether she will become a regular member.

Meanwhile, Senator Susan Collins, Republican of Maine, is at work on her own health care plan. She and Senator Lisa Murkowski, Republican of Alaska have opposed efforts to strip funding from Planned Parenthood. Senators from states like Ohio that took the Medicaid expansion have also expressed reservations about the A.H.C.A.’s cuts to that program. Republican moderates will have a crucial role to play in the coming months, as the Senate decides what, if any, provisions of the House bill it will keep. It will be up to them to make sure women’s health is not treated as a joke.